Frequency and Number of Reports of Imported Diseases

Ms Joan Pereira asked the Minister for Health (a) how many cases of imported diseases has been reported in the last three years; and (b) how can the Ministry work with these source countries to minimise the occurrences of these diseases from reaching our shores.

In the last three years, there were two reported cases of severe emerging infectious diseases brought in by infected travellers:

In May 2019, we had an imported Monkeypox case from Nigeria. Monkeypox is a rare infection transmitted primarily from animals to humans and occurring mainly in central and west Africa. It causes fever and rash, and can occasionally be fatal.

In May 2016, we had an imported Zika case from Brazil. Although Zika does not generally cause serious illness, it may cause microcephaly in babies of infected pregnant women. Subsequently in August 2016, we reported our first locally-transmitted cases, which were not linked to the case from Brazil, but to another unidentified imported case of a different Asian lineage of Zika.

In addition to these severe emerging diseases, there are also many common infectious diseases that are imported into Singapore. Between 2016 to 2018, there were 1,869 cases of imported infections, of which dengue and traveller's diarrhoea were the most common causes, followed by malaria, chikungunya and measles.

Given the high volume of international travel, there is always a risk that travellers may bring in emerging infectious diseases. MOH works closely with international bodies and foreign counterparts to prevent importation of such diseases. We also work with our local healthcare institutions and relevant government agencies to prevent, detect and contain such imported cases.

At the international level, the World Health Organization (WHO) requires countries to notify it of events that constitute a "public health emergency of international concern", and may ask them to undertake measures to limit the risk of spread across borders. WHO keeps member nations informed of such incidents and may recommend public health measures if necessary. By working with WHO and other countries, we can better monitor the emerging global situation, obtain early warnings of public health threats, assess the potential risk to us and take early measures to prevent and detect such diseases.

Where appropriate, we institute measures at our borders. For example, temperature screening is currently conducted for all travellers from the Middle East to detect cases of the Middle East respiratory syndrome coronavirus (MERS-CoV), an infection that can cause severe respiratory illness. However, temperature screening may not be effective against other diseases such as Zika because most infected persons have no or mild symptoms. There is also an incubation period during which an infected person may not display any symptom.

MOH therefore works with our healthcare institutions and professionals to maintain vigilance. We send out alerts and circulars to keep our hospitals, polyclinics and primary care doctors updated on the latest disease situation, and to inform them of the criteria for evaluating and reporting possible cases. The recent Monkeypox case for example was detected by vigilant doctors at the Tan Tock Seng Hospital and National Centre for Infectious Diseases.

Finally, when we have a confirmed case, we will take decisive actions to contain the spread and treat the patient. MOH has worked with healthcare providers and relevant government agencies to isolate the case, conduct contact tracing and quarantine close contacts if necessary, and carry our environmental disinfection.

The public has an important role to play too. We encourage members of the public to keep up to date with the Government's travel advisories and exercise personal responsibility and hygiene during their travels, especially to affected countries.  This way, it will protect you against the risk being infected and bringing emerging diseases to Singapore.